Isolated Musculocutaneous Nerve Injury after fall from height

Dr Sameer Haveri, Patil S, Udapudi S V, Taj F T

Dr Sameer Haveri, Patil S, Udapudi S V, Taj F T

Keywords: Musculocutaneous nerve, biceps brachii injury

Abstract

A 22 year previously healthy man presented to Orthopaedic department of our hospital with inability to flex his left elbow since 6 months. He complained of no pain. 6 months back he
fell from a height of around 20 feet, when he sustained injury to his left shoulder, elbow and left leg. X-rays of shoulder and elbow showed no fracture.
On clinical examination and investigations (X-rrays, USG, MRI, EMG/NCV) he was diagnosed as isolated musculocutaneous nerve injury. He was treated in the form of physiotherapy by
electrical muscle stimulation and strengthening of elbow flexors. At the latest follow up of 2 years he has regained normal muscle mass and power of elbow flexion. He is able to lift
heavy weights without any discomfort or pain. He is back to his heavy labour work.

References

1. Braddom RL, Wolfe C. Musculocutaneous nerve injury after heavy exercise. Arch Phys Med Rehabil. 1978; 59:290-3.
2. Dundore DE, DeLisa JA. Musculocutaneous nerve palsy: an isolated complication of surgery. Arch Phys Med Rehabil. 1979;60:130-3.
3. Flatow EL, Bigliani LH, April EW. An anatomic study of the musculocutaneous nerve and its relationship to the coracoids process. Clin Orthop. 1989; 244:166—71.
4. KimSM, GoodrichJA. Isolated proximalmusculocutaneous nerve palsy: case report. Arch Phys Med Rehabil. 1984; 65:735-6.
5. Mastaglia FL. Musculocutaneous neuropathy after strenuous physical activity. Med J Aust. 1986; 145:153- 4.
6. Mumenthaler M. Lesions of individual nerves in the shoulder arm region. In: Mumenthaler M, Schliak H, editors. Peripheral nerve lesions. New York: Thieme Medical Publishers; 1991; 222-4.
7. Sander HW, Quinto CM, Elinzano H, Chokroverty S. Carpet carrier’s palsy: musculocutaneous neuropathy. Neurology. 1997; 48:1731-2.
8. Simonetti S. Musculocutaneous nerve lesion after strenuous physical activity. Muscle Nerve 1999; 22:647-9 [Letter].
9. Swain R. Musculocutaneous nerve entrapment: a case report. Clin J Sport Med. 1995; 5:196—8.
10. Yilmaz, Cengiz, Eskandari, Metin M,Colak, Mehmet .Traumatic musculocutaneous neuropathy: a case report. Archives of Orthopaedic & Trauma Surgery. 2005;125(6):414-416.
11. DeFranco MJ, Schickendantz MS. Isolated Musculocutaneous Nerve Injury in a Professional Fast-Pitch Softball Player A Case Report. Am J Sports Med. 2008; 36 (9):1821-1823.